A nurse is preparing to administer methotrexate to a client who is experiencing an ectopic pregnancy. Which of the following actions should the nurse take?

Choice A rationale Methotrexate primarily affects rapidly dividing cells and can cause gastrointestinal side effects, but dark-colored stools are not a commonly expected adverse effect. Dark stools might indicate gastrointestinal bleeding, which would be a concerning symptom requiring immediate investigation, not a typical drug effect. Choice B rationale Methotrexate is a hazardous drug classified as a chemotherapy agent. Nurses must wear appropriate personal protective equipment, including two pairs of gloves, when preparing and administering this medication to prevent skin exposure and absorption, which can lead to systemic toxicity due to its cytotoxic properties. Choice C rationale Methotrexate for ectopic pregnancy is typically administered intramuscularly, not subcutaneously. Intramuscular administration ensures systemic absorption and distribution to target rapidly dividing trophoblastic cells. Subcutaneous injection would not provide adequate drug delivery for this indication and may lead to localized reactions. Choice D rationale Methotrexate is a teratogenic medication, meaning it can cause birth defects. To prevent fetal exposure and potential harm, clients are advised to avoid pregnancy during and for a period after treatment. Using barrier contraception like condoms for at least 7 days, or longer as advised, is crucial to prevent conception and protect a potential fetus.